Squires Janet E, Moralejo Donna, Lefort Sandra M
Knowledge Utilization Studies Program, Faculty of Nursing, University of Alberta, Edmonton, Alberta T6G 0P2, Canada.
Implement Sci. 2007 Jun 5;2:17. doi: 10.1186/1748-5908-2-17.
Policies and procedures (P&Ps) have been suggested as one possible strategy for moving research evidence into practice among nursing staff in hospitals. Research in the area of P&Ps is limited, however. This paper explores: 1) nurses' use of eight specific research-based practices (RBPs) and RBP overall, 2) nurses' use and understanding of P&Ps, and 3) the role of P&Ps in promoting research utilization.
Staff nurses from the eight health regions governing acute care services across the Canadian province of Newfoundland and Labrador completed an anonymous questionnaire regarding their use of eight RBPs and associated P&Ps. Data were also obtained from authorities in six of the eight regions about existing relevant P&Ps. We used descriptive statistics and multivariate regression analysis to assess the relationship between key independent variables and self-reported use of RBP.
Use of the eight RBPs ranged from 7.8% to 88.6%, depending on the practice. Nurses ranked P&P manuals as their number one source of practice knowledge. Most respondents (84.8%) reported that the main reason they consult the P&P manual is to confirm they are practicing according to agency rules. Multivariate regression analysis identified three significant predictors of being a user versus non-user of RBP overall: awareness, awareness by regular use, and persuasion. Six significant predictors of being a consistent versus less consistent user of RBP overall were also identified: perception of P&P existence, unit, nursing experience, personal experience as a source of practice knowledge, number of existing research-based P&Ps, and lack of time as a barrier to consulting P&P manuals.
Findings suggest that nurses use P&Ps to guide their practice. However, the mere existence of P&Ps is not sufficient to translate research into nursing practice. Individual and organizational factors related to nurses' understanding and use of P&Ps also play key roles. Thus, moving research evidence into practice will require careful interplay between the organization and the individual. P&Ps may be the interface through which this occurs.
政策与程序（P&P）已被视为将研究证据应用于医院护理人员实践的一种可能策略。然而，P&P领域的研究有限。本文探讨：1）护士对八项基于研究的具体实践（RBP）及总体RBP的使用情况；2）护士对P&P的使用与理解；3）P&P在促进研究应用方面的作用。
来自加拿大纽芬兰与拉布拉多省负责急性护理服务的八个卫生区域的注册护士完成了一份关于其对八项RBP及相关P&P使用情况的匿名问卷。还从八个区域中的六个区域的管理部门获取了有关现有相关P&P的数据。我们使用描述性统计和多元回归分析来评估关键自变量与自我报告的RBP使用之间的关系。
八项RBP的使用比例从7.8%到88.6%不等，具体取决于实践内容。护士将P&P手册列为实践知识的首要来源。大多数受访者（84.8%）表示，他们查阅P&P手册的主要原因是确认自己是按照机构规定进行操作的。多元回归分析确定了总体上成为RBP使用者与非使用者的三个显著预测因素：知晓度、经常使用带来的知晓度以及说服力。还确定了总体上成为RBP持续使用者与较少持续使用者的六个显著预测因素：对P&P存在的认知、科室、护理经验、作为实践知识来源的个人经验、现有基于研究的P&P的数量以及缺乏时间作为查阅P&P手册的障碍。
研究结果表明护士利用P&P来指导实践。然而，仅仅存在P&P不足以将研究转化为护理实践。与护士对P&P的理解和使用相关的个体及组织因素也起着关键作用。因此，将研究证据转化为实践需要组织与个体之间的谨慎互动。P&P可能是发生这种互动的界面。
